RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study
Guide, Practice Exam Questions and Answers, Exam Prep Test Bank, ECG
Rhythm Interpretation, Cardiac Monitoring and Telemetry Analysis,
Dysrhythmia Recognition and Management, Cardiovascular Patient
Assessment, Hemodynamic Monitoring Principles, Acute Care Nursing
Decision-Making, and Detailed Rationales for Competency Exam Success
Question 1: What does the P wave represent? A. Atrial depolarization B. Ventricular
depolarization C. Atrial repolarization D. Ventricular repolarization CORRECT ANSWER:
A. Atrial depolarization Rationale: The P wave represents atrial depolarization.
Question 2: What is the normal duration of the PR interval? A. 0.04-0.08 seconds B.
0.12-0.20 seconds C. 0.20-0.30 seconds D. 0.10-0.12 seconds CORRECT ANSWER: B.
0.12-0.20 seconds Rationale: The normal PR interval is 0.12 to 0.20 seconds.
Question 3: What does the QRS complex represent? A. Atrial depolarization B.
Ventricular depolarization C. Ventricular repolarization D. Atrial repolarization
CORRECT ANSWER: B. Ventricular depolarization Rationale: The QRS complex
represents ventricular depolarization.
Question 4: What is the normal duration of the QRS complex? A. Less than 0.12
seconds B. 0.12-0.20 seconds C. 0.20-0.30 seconds D. Greater than 0.30 seconds
CORRECT ANSWER: A. Less than 0.12 seconds Rationale: The normal QRS duration
is less than 0.12 seconds.
Question 5: What does the T wave represent? A. Atrial depolarization B. Ventricular
depolarization C. Ventricular repolarization D. Atrial repolarization CORRECT ANSWER:
C. Ventricular repolarization Rationale: The T wave represents ventricular
repolarization.
Question 6: What is the normal heart rate for a sinus rhythm? A. 40-60 bpm B. 60-100
bpm C. 100-150 bpm D. 20-40 bpm CORRECT ANSWER: B. 60-100 bpm Rationale:
Normal sinus rhythm has a rate of 60-100 bpm.
Question 7: What is the intrinsic rate of the SA node? A. 20-40 bpm B. 40-60 bpm C.
60-100 bpm D. 100-150 bpm CORRECT ANSWER: C. 60-100 bpm Rationale: The SA
node's intrinsic rate is 60-100 bpm.
Question 8: What is the intrinsic rate of the AV junction? A. 20-40 bpm B. 40-60 bpm
C. 60-100 bpm D. 100-150 bpm CORRECT ANSWER: B. 40-60 bpm Rationale: The AV
junction's intrinsic rate is 40-60 bpm.
Question 9: What is the intrinsic rate of the ventricles? A. 20-40 bpm B. 40-60 bpm C.
60-100 bpm D. 100-150 bpm CORRECT ANSWER: A. 20-40 bpm Rationale: The
ventricles' intrinsic rate is 20-40 bpm.
Question 10: Where is the V1 electrode placed? A. 4th intercostal space, right sternal
border B. 4th intercostal space, left sternal border C. 5th intercostal space,
midclavicular line D. 5th intercostal space, anterior axillary line CORRECT ANSWER: A.
,4th intercostal space, right sternal border Rationale: V1 is placed at the 4th
intercostal space, right sternal border.
Question 11: Where is the V2 electrode placed? A. 4th intercostal space, right sternal
border B. 4th intercostal space, left sternal border C. 5th intercostal space,
midclavicular line D. 5th intercostal space, anterior axillary line CORRECT ANSWER: B.
4th intercostal space, left sternal border Rationale: V2 is placed at the 4th intercostal
space, left sternal border.
Question 12: Where is the V4 electrode placed? A. 4th intercostal space, right sternal
border B. 4th intercostal space, left sternal border C. 5th intercostal space,
midclavicular line D. 5th intercostal space, midaxillary line CORRECT ANSWER: C. 5th
intercostal space, midclavicular line Rationale: V4 is placed at the 5th intercostal
space, midclavicular line.
Question 13: What is the primary purpose of telemetry monitoring? A. To measure
blood pressure continuously B. To continuously monitor the cardiac rhythm C. To
measure oxygen saturation D. To assess respiratory rate CORRECT ANSWER: B. To
continuously monitor the cardiac rhythm Rationale: Telemetry is used for continuous
cardiac rhythm monitoring.
Question 14: What is a common cause of ECG artifact? A. Proper skin preparation B.
Loose or dry electrodes C. Patient lying still D. Using fresh electrodes CORRECT
ANSWER: B. Loose or dry electrodes Rationale: Loose or dry electrodes cause artifact
on the ECG.
Question 15: Which lead is best for monitoring P waves? A. Lead II B. Lead V1 C. Lead
V5 D. Lead aVF CORRECT ANSWER: B. Lead V1 Rationale: Lead V1 is often best for
visualizing P waves.
Question 16: What defines sinus bradycardia? A. Heart rate < 60 bpm B. Heart rate >
100 bpm C. Irregular rhythm D. Absent P waves CORRECT ANSWER: A. Heart rate < 60
bpm Rationale: Sinus bradycardia is defined as a sinus rhythm with a rate < 60 bpm.
Question 17: What is the first-line medication for symptomatic sinus bradycardia?
A. Epinephrine B. Atropine C. Amiodarone D. Adenosine CORRECT ANSWER: B.
Atropine Rationale: Atropine is the first-line drug for symptomatic bradycardia.
Question 18: What is the initial adult dose of Atropine for bradycardia? A. 0.1 mg IV
B. 0.5 mg IV C. 1.0 mg IV D. 2.0 mg IV CORRECT ANSWER: B. 0.5 mg IV Rationale: The
initial dose of Atropine is 0.5 mg IV every 3-5 minutes.
Question 19: What is the maximum total dose of Atropine for bradycardia? A. 1 mg
B. 2 mg C. 3 mg D. 5 mg CORRECT ANSWER: C. 3 mg Rationale: The maximum total
dose of Atropine is 3 mg.
Question 20: What is a common cause of sinus tachycardia? A. Hypothermia B.
Hypovolemia C. Increased vagal tone D. Beta-blocker use CORRECT ANSWER: B.
, Hypovolemia Rationale: Hypovolemia, fever, and pain are common causes of sinus
tachycardia.
Question 21: What characterizes a Premature Atrial Complex (PAC)? A. Wide QRS
complex B. Early, abnormal P wave C. Absent P wave D. Prolonged PR interval
CORRECT ANSWER: B. Early, abnormal P wave Rationale: PACs have an early,
abnormal P wave morphology.
Question 22: What characterizes a Premature Ventricular Complex (PVC)? A.
Narrow QRS complex B. Wide, bizarre QRS complex C. Normal P wave before QRS D.
Regular rhythm CORRECT ANSWER: B. Wide, bizarre QRS complex Rationale: PVCs
have a wide, bizarre QRS complex > 0.12 seconds.
Question 23: What is the R-on-T phenomenon? A. A PVC occurring on the T wave B. A
P wave on the T wave C. A T wave on the QRS D. A QRS on the P wave CORRECT
ANSWER: A. A PVC occurring on the T wave Rationale: R-on-T occurs when a PVC
falls on the T wave, risking VT/VF.
Question 24: What is the atrial rate in Atrial Fibrillation? A. 60-100 bpm B. 150-250
bpm C. 250-350 bpm D. 350-600 bpm CORRECT ANSWER: D. 350-600 bpm Rationale:
The atrial rate in AFib is 350-600 bpm.
Question 25: What is the ventricular rhythm in Atrial Fibrillation? A. Regular B.
Irregularly irregular C. Completely blocked D. Progressively slowing CORRECT
ANSWER: B. Irregularly irregular Rationale: AFib is characterized by an irregularly
irregular ventricular rhythm.
Question 26: What is the primary complication of Atrial Fibrillation? A. Myocardial
infarction B. Thrombus formation and stroke C. Heart block D. Pulmonary embolism
CORRECT ANSWER: B. Thrombus formation and stroke Rationale: Blood stasis in the
atria can cause thrombi, leading to stroke.
Question 27: What ECG finding characterizes Atrial Flutter? A. Absent P waves B.
Sawtooth flutter waves C. Wide QRS complexes D. Prolonged PR interval CORRECT
ANSWER: B. Sawtooth flutter waves Rationale: Atrial flutter shows characteristic
sawtooth flutter waves.
Question 28: What is the typical atrial rate in Atrial Flutter? A. 150-200 bpm B. 250-
350 bpm C. 350-600 bpm D. > 600 bpm CORRECT ANSWER: B. 250-350 bpm
Rationale: The atrial rate in atrial flutter is typically 250-350 bpm.
Question 29: What is the typical heart rate range for SVT? A. 100-150 bpm B. 150-250
bpm C. 250-350 bpm D. > 350 bpm CORRECT ANSWER: B. 150-250 bpm Rationale:
SVT typically has a rate of 150-250 bpm.
Question 30: What is the first-line medication for stable SVT? A. Amiodarone B.
Adenosine C. Atropine D. Epinephrine CORRECT ANSWER: B. Adenosine Rationale:
Adenosine is the first-line drug for stable SVT.
Guide, Practice Exam Questions and Answers, Exam Prep Test Bank, ECG
Rhythm Interpretation, Cardiac Monitoring and Telemetry Analysis,
Dysrhythmia Recognition and Management, Cardiovascular Patient
Assessment, Hemodynamic Monitoring Principles, Acute Care Nursing
Decision-Making, and Detailed Rationales for Competency Exam Success
Question 1: What does the P wave represent? A. Atrial depolarization B. Ventricular
depolarization C. Atrial repolarization D. Ventricular repolarization CORRECT ANSWER:
A. Atrial depolarization Rationale: The P wave represents atrial depolarization.
Question 2: What is the normal duration of the PR interval? A. 0.04-0.08 seconds B.
0.12-0.20 seconds C. 0.20-0.30 seconds D. 0.10-0.12 seconds CORRECT ANSWER: B.
0.12-0.20 seconds Rationale: The normal PR interval is 0.12 to 0.20 seconds.
Question 3: What does the QRS complex represent? A. Atrial depolarization B.
Ventricular depolarization C. Ventricular repolarization D. Atrial repolarization
CORRECT ANSWER: B. Ventricular depolarization Rationale: The QRS complex
represents ventricular depolarization.
Question 4: What is the normal duration of the QRS complex? A. Less than 0.12
seconds B. 0.12-0.20 seconds C. 0.20-0.30 seconds D. Greater than 0.30 seconds
CORRECT ANSWER: A. Less than 0.12 seconds Rationale: The normal QRS duration
is less than 0.12 seconds.
Question 5: What does the T wave represent? A. Atrial depolarization B. Ventricular
depolarization C. Ventricular repolarization D. Atrial repolarization CORRECT ANSWER:
C. Ventricular repolarization Rationale: The T wave represents ventricular
repolarization.
Question 6: What is the normal heart rate for a sinus rhythm? A. 40-60 bpm B. 60-100
bpm C. 100-150 bpm D. 20-40 bpm CORRECT ANSWER: B. 60-100 bpm Rationale:
Normal sinus rhythm has a rate of 60-100 bpm.
Question 7: What is the intrinsic rate of the SA node? A. 20-40 bpm B. 40-60 bpm C.
60-100 bpm D. 100-150 bpm CORRECT ANSWER: C. 60-100 bpm Rationale: The SA
node's intrinsic rate is 60-100 bpm.
Question 8: What is the intrinsic rate of the AV junction? A. 20-40 bpm B. 40-60 bpm
C. 60-100 bpm D. 100-150 bpm CORRECT ANSWER: B. 40-60 bpm Rationale: The AV
junction's intrinsic rate is 40-60 bpm.
Question 9: What is the intrinsic rate of the ventricles? A. 20-40 bpm B. 40-60 bpm C.
60-100 bpm D. 100-150 bpm CORRECT ANSWER: A. 20-40 bpm Rationale: The
ventricles' intrinsic rate is 20-40 bpm.
Question 10: Where is the V1 electrode placed? A. 4th intercostal space, right sternal
border B. 4th intercostal space, left sternal border C. 5th intercostal space,
midclavicular line D. 5th intercostal space, anterior axillary line CORRECT ANSWER: A.
,4th intercostal space, right sternal border Rationale: V1 is placed at the 4th
intercostal space, right sternal border.
Question 11: Where is the V2 electrode placed? A. 4th intercostal space, right sternal
border B. 4th intercostal space, left sternal border C. 5th intercostal space,
midclavicular line D. 5th intercostal space, anterior axillary line CORRECT ANSWER: B.
4th intercostal space, left sternal border Rationale: V2 is placed at the 4th intercostal
space, left sternal border.
Question 12: Where is the V4 electrode placed? A. 4th intercostal space, right sternal
border B. 4th intercostal space, left sternal border C. 5th intercostal space,
midclavicular line D. 5th intercostal space, midaxillary line CORRECT ANSWER: C. 5th
intercostal space, midclavicular line Rationale: V4 is placed at the 5th intercostal
space, midclavicular line.
Question 13: What is the primary purpose of telemetry monitoring? A. To measure
blood pressure continuously B. To continuously monitor the cardiac rhythm C. To
measure oxygen saturation D. To assess respiratory rate CORRECT ANSWER: B. To
continuously monitor the cardiac rhythm Rationale: Telemetry is used for continuous
cardiac rhythm monitoring.
Question 14: What is a common cause of ECG artifact? A. Proper skin preparation B.
Loose or dry electrodes C. Patient lying still D. Using fresh electrodes CORRECT
ANSWER: B. Loose or dry electrodes Rationale: Loose or dry electrodes cause artifact
on the ECG.
Question 15: Which lead is best for monitoring P waves? A. Lead II B. Lead V1 C. Lead
V5 D. Lead aVF CORRECT ANSWER: B. Lead V1 Rationale: Lead V1 is often best for
visualizing P waves.
Question 16: What defines sinus bradycardia? A. Heart rate < 60 bpm B. Heart rate >
100 bpm C. Irregular rhythm D. Absent P waves CORRECT ANSWER: A. Heart rate < 60
bpm Rationale: Sinus bradycardia is defined as a sinus rhythm with a rate < 60 bpm.
Question 17: What is the first-line medication for symptomatic sinus bradycardia?
A. Epinephrine B. Atropine C. Amiodarone D. Adenosine CORRECT ANSWER: B.
Atropine Rationale: Atropine is the first-line drug for symptomatic bradycardia.
Question 18: What is the initial adult dose of Atropine for bradycardia? A. 0.1 mg IV
B. 0.5 mg IV C. 1.0 mg IV D. 2.0 mg IV CORRECT ANSWER: B. 0.5 mg IV Rationale: The
initial dose of Atropine is 0.5 mg IV every 3-5 minutes.
Question 19: What is the maximum total dose of Atropine for bradycardia? A. 1 mg
B. 2 mg C. 3 mg D. 5 mg CORRECT ANSWER: C. 3 mg Rationale: The maximum total
dose of Atropine is 3 mg.
Question 20: What is a common cause of sinus tachycardia? A. Hypothermia B.
Hypovolemia C. Increased vagal tone D. Beta-blocker use CORRECT ANSWER: B.
, Hypovolemia Rationale: Hypovolemia, fever, and pain are common causes of sinus
tachycardia.
Question 21: What characterizes a Premature Atrial Complex (PAC)? A. Wide QRS
complex B. Early, abnormal P wave C. Absent P wave D. Prolonged PR interval
CORRECT ANSWER: B. Early, abnormal P wave Rationale: PACs have an early,
abnormal P wave morphology.
Question 22: What characterizes a Premature Ventricular Complex (PVC)? A.
Narrow QRS complex B. Wide, bizarre QRS complex C. Normal P wave before QRS D.
Regular rhythm CORRECT ANSWER: B. Wide, bizarre QRS complex Rationale: PVCs
have a wide, bizarre QRS complex > 0.12 seconds.
Question 23: What is the R-on-T phenomenon? A. A PVC occurring on the T wave B. A
P wave on the T wave C. A T wave on the QRS D. A QRS on the P wave CORRECT
ANSWER: A. A PVC occurring on the T wave Rationale: R-on-T occurs when a PVC
falls on the T wave, risking VT/VF.
Question 24: What is the atrial rate in Atrial Fibrillation? A. 60-100 bpm B. 150-250
bpm C. 250-350 bpm D. 350-600 bpm CORRECT ANSWER: D. 350-600 bpm Rationale:
The atrial rate in AFib is 350-600 bpm.
Question 25: What is the ventricular rhythm in Atrial Fibrillation? A. Regular B.
Irregularly irregular C. Completely blocked D. Progressively slowing CORRECT
ANSWER: B. Irregularly irregular Rationale: AFib is characterized by an irregularly
irregular ventricular rhythm.
Question 26: What is the primary complication of Atrial Fibrillation? A. Myocardial
infarction B. Thrombus formation and stroke C. Heart block D. Pulmonary embolism
CORRECT ANSWER: B. Thrombus formation and stroke Rationale: Blood stasis in the
atria can cause thrombi, leading to stroke.
Question 27: What ECG finding characterizes Atrial Flutter? A. Absent P waves B.
Sawtooth flutter waves C. Wide QRS complexes D. Prolonged PR interval CORRECT
ANSWER: B. Sawtooth flutter waves Rationale: Atrial flutter shows characteristic
sawtooth flutter waves.
Question 28: What is the typical atrial rate in Atrial Flutter? A. 150-200 bpm B. 250-
350 bpm C. 350-600 bpm D. > 600 bpm CORRECT ANSWER: B. 250-350 bpm
Rationale: The atrial rate in atrial flutter is typically 250-350 bpm.
Question 29: What is the typical heart rate range for SVT? A. 100-150 bpm B. 150-250
bpm C. 250-350 bpm D. > 350 bpm CORRECT ANSWER: B. 150-250 bpm Rationale:
SVT typically has a rate of 150-250 bpm.
Question 30: What is the first-line medication for stable SVT? A. Amiodarone B.
Adenosine C. Atropine D. Epinephrine CORRECT ANSWER: B. Adenosine Rationale:
Adenosine is the first-line drug for stable SVT.
